amoxicillin + clarithromycin + bismuth potassium citrate + proton pump inhibitor

This drug is a fixed combination regimen used primarily for the eradication of Helicobacter pylori infection. It consists of four components: - Amoxicillin (a beta-lactam antibiotic that inhibits bacterial cell wall synthesis) - Clarithromycin (a macrolide antibiotic that inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit) - Bismuth potassium citrate (provides bismuth ions with antimicrobial and mucosal protective effects against H. pylori) - Proton pump inhibitor (PPI; e.g., omeprazole, lansoprazole, rabeprazole, or esomeprazole), which suppresses gastric acid secretion by inhibiting the H+/K+ ATPase in gastric parietal cells. The combination acts synergistically to eradicate H. pylori by attacking multiple targets—bacterial cell wall and protein synthesis inhibition, direct bactericidal action from bismuth salts, and enhanced antibiotic efficacy through increased gastric pH from PPI use. This quadruple therapy is recommended as a first-line treatment in areas with high resistance rates to clarithromycin or metronidazole and has demonstrated high eradication rates even in resistant strains[1][2][4].

Other names

bismuth-containing quadruple therapyRBAC regimenB-quadruple therapy